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News note

Desirable rate of exclusive breastfeeding, still a distant goal in most of the Arab world

AMMAN, 4 August 2005 – In spite of notable achievements by countries like Syria and Egypt having reached more than fifty percent of exclusive breastfeeding at their national levels, the Middle East and North Africa region has yet to engage in more resolute action to ensure that infants are breastfed between 0-6 months of age.

Exclusive breastfeeding rates increased by 10% over the past decade in the region and improvements were also noted in complementary feeding and in continued breastfeeding for the second year of life. However, the lack of continued support and irregular monitoring of the process have led to a recent decline in breastfeeding and in the number of hospitals promoting the practice.

Today, less than half of mothers in the region exclusively breastfeed their infants for up to three months, said UNICEF today amidst ongoing celebrations of the World Breastfeeding Week. In addition, the poor nutrition and health status of women and female children in lowest-income countries like Djibouti, Yemen, Sudan (and now Iraq) create an inter-generational vicious circle affecting the nutritional status of newborns at a very early stage.

The duration of breastfeeding is also gradually declining in most countries, especially in urban areas. As a result, inappropriate complementary feeding and weaning practices are major causes of child under nutrition, which is highest in the age group between six months and two years. Mixed breast and bottle feeding as early as the first month, and the premature introduction of complementary food are commonly found in all countries in the region. Infant formula is often diluted with unsafe water in non-sterile bottles.

Dealing with varied socioeconomic contrasts

Despite breastfeeding’s numerous recognized advantages over artificial feeding, several high-income countries in the region (Bahrain, Kuwait, Qatar, Oman, UAE and Saudi Arabia) maintain patterns similar as European industrialized countries, where exclusive breastfeeding is still below 35% (12% in Qatar, Kuwait; 31% in Oman; 31% in Saudi Arabia and 34% in Bahrain and the UAE).

“Encouraging exclusive breastfeeding has to become a high priority in all sectors of society. Compared to breastfed babies, formula-fed babies get sick more often and are more likely to die in infancy or childhood. We know of good practices in low-income communities where empowered mothers are increasingly showing concrete intent to breastfeed”, said Dr. Mahendra Sheth, UNICEF Regional Health and Nutrition Adviser for the Middle East and North Africa.

“Delivering proper nutrition messages and educating the general public, particularly child care providers on the absolute benefits of breastfeeding are key interventions we have yet to apply comprehensively in the region”, Dr. Sheth added.

The Baby-friendly Hospital Initiative

In some countries where the advantages of breastfeeding have been widely publicized and where the Baby-friendly Hospital Initiative (BFHI) has been implemented, breastfeeding rates are increasing. Countries like Iran, Iraq, Jordan, Morocco, Oman, Syria, and countries in the Gulf countries have successfully adopted breastfeeding promotion and BFHI since the 1990’s.

Launched in 1991, the Baby-Friendly Hospital Initiative is an effort by UNICEF and the World Health Organization to ensure that all maternity centres become local leagues of breastfeeding support. Since the BFHI began, more than 15,000 facilities in 134 countries have been awarded Baby-Friendly status. In many areas where hospitals have been designated Baby-Friendly, more mothers are breastfeeding their infants, and child health has improved.

About Breastfeeding and Complementary Feeding

Breastmilk is the perfect nourishment for babies for the first six months of life. Alone it contains all the nutrients, antibodies, hormones and immune factors that a baby needs. If the drive for universal breastfeeding in the first six months of life is accomplished, an estimated 1.5 million lives could be saved each year.

International experts recommend exclusive breastfeeding of infants for about six months and breastfeeding with good quality complementary foods up to two years. Breast milk contains nutritional substances ideal in quantity and quality for optimal growth and development of infants. In addition to its nutritional value, breast milk favourably changes the pH of stools and the intestinal flora, thus protecting against bacterial diarrhoea.